China’s reclassification of Novel Coronavirus diagnosis results in spikes in infections and death toll

After a flurry of hopeful reports that the number of new infections was beginning to decline, China reported significant increases in both new coronavirus diagnoses and suspected coronavirus deaths late on February 12. As reported by CBS News , new coronavirus diagnoses in China totaled 14,480 and deaths totaled 242. Of the new diagnoses, some 13,332 (92 percent) and half of the reported deaths are ascribable to China’s adoption of a new, broader definition of a confirmed coronavirus cases. The new definition was enabled by the utilization of lung imagining, in addition to the standard nucleic acid test protocol, to identify new infections.

While the expansion of the epidemic is troubling (though seemingly not surprising), China’s revised numbers are a positive development in at least three keys ways critical to the eventual management and control of the virus’s spread. First, the numbers demonstrate that China is investing time and resources into rapidly reaching a better and more accurate means of diagnosing and better understanding the illness caused by the virus. In fact, more accurate diagnoses are important to limit the spread and impact of the illness but, at least in the near term, they are not helpful to China’s efforts to suggest that it is gaining control over the epidemic or its economic stability. That China sees the benefit of investing in developing a better medical understanding is a good sign.

Those realities play into the second point, which is that China’s revised numbers help bolster the credibility of its data and the justified reliance on that data by third parties trying to track the trajectory of the epidemic. China had a slow start regarding transparency, delaying the release of reports of the illness and then underplaying its spread and numbers. The new diagnostic protocols (and the concomitant increase in cases and deaths) does not aid China’s efforts to contain the now international damage it is suffering at many levels, nor does it reassure its own populace that the government has gained control over the spread of the virus internally. But it does show that, at least until demonstrated otherwise, China sees the benefit of valid data even if the data is derived at the expense of its own reputation. That gives greater credence to the data.

Finally, about the people, the new diagnostic tools enable China to offer better and faster treatment for its affected citizens. Knowing who actually has the virus is key to quarantine and other responsive measures. In addition, knowing who has the virus earlier may lead to better and more timely interventions which, in turn, may lessen the mortality rate. While the urgent construction of temporary hospitals belies chaos in a medical response, at least there is a chance that these newly diagnosed patients will get the right treatment sooner.

~~ David M. Walsh